Second Nature (3 page)

“Of course. I know that. I’m going to be a reconstructive surgeon. And my mentor, Dr. Grigsby, pioneered full-face transplant surgery, well … years and years ago.”

“Does she have a new technique? Does she need illustrations?” I asked.

“No. No. I … She just moved here from London, actually, to head up a team at UIC. And I told her about you. I told her about your career. I told her about your … face.”
Huh?
I thought. Then Eliza said, “I was thinking you might be hoping for a face transplant.”

“A what?”

“A face transplant.”

“For me?”

“Well, yes.”

“I don’t need a face transplant.” I almost laughed again.

“That’s the thing,” Eliza said. “If you thought you
needed
to have a face—that is, a new face—you probably shouldn’t be considered. If you couldn’t work or have a social life, for example, with your face the way it is, you really shouldn’t be a candidate for a new one.”

I sat down on my bed, flummoxed. “Eliza, this sounds like
Alice in Wonderland
. Like, if you’re well read, you shouldn’t wear red … or whatever. This is very thoughtful, but you know how many surgeries I’ve already had? Why would I do this? Not to mention, I don’t have a million dollars or so sitting around.”

“Whatever your insurance didn’t cover, the hospital would. There’s a fund.”

“Eliza,” I said, suddenly eager to be asleep, oblivious. “It’s just really awkward. You might as well suggest I … hatch fertilized eggs from an alien. This is so not on my radar.”

“I’m sorry. This was probably inappropriate. You must think I’m trying to score success points with my boss. It is not that. It was something my husband said. When he was in college, he thought he might be a teacher. He helped with summer sports programs at Holy Angels. He graduated from there.”

“I played … uh, hoops, summer league.” I didn’t try to say “basketball.” I didn’t say “basketball” or any words that began with “B” or “P” if I could help it. Not having lips is a disadvantage with plosives. I’d avoided them for so long, I was virtually my own simultaneous translator.

“Right. Ben transferred to your school because there was too much attention at public school about him—but that doesn’t matter.”

Then I remembered where I’d heard the name Ben Cappadora: back when I was in first grade. He was the boy who was kidnapped and returned, whose parents once lived in Chester, where my parents had lived and where my Grandma and Grandpa Caruso still did. The Cappadoras were a sort of local legend, the unluckiest family around.

“Sure. Everyone knows about Ben. And his brother—didn’t he make a movie?”

“Vincent. My brother-in-law. Yes, He did. He won an Oscar. But it was only a documentary, not like, well,
Star Wars
. He’s a little famous.”

“But how does this involve me?”

“I think Dr. Grigsby will probably kill me, also, in doing this,” Eliza said, as though talking to herself. I was curious now. “Don’t be angry with me.”

“I’m not angry,” I said. “What did Ben say?”

“How cute you were, and really tough too. He said you played to win,” Eliza said. “Oh, dear. Dr. Grigsby seeks out patients who are tough. You have to be tough to go through this procedure.”

“Well,” I said. “I did always play to win, I guess. Maybe I still do. But I don’t think I want to take this opportunity from someone else who really—”

“I get it. So, maybe just the coffee will be good.”

“At UIC? Not a chance,” I said.

“We’ll go to Lotta Latte,” she said.

“Now you’ve got a deal.”

We parted with a promise to meet sometime. I wrote her home phone number on a piece of paper that I folded and tucked into a corner of the frame that held my mother’s photo, one of three framed pictures I kept by my bedside—her, my father, and my own eighth-grade graduation picture.

In my photo, I was sitting on a rough wooden bench, outdoors, wearing cuffed jeans, my arms circling one drawn-up knee. My lustrous hair, shiny as a horse chestnut and exactly that color—a replica of my mother’s—was drawn over one shoulder in a thick sheet. I recalled myself as a little girl, wearing a red taffeta skirt that spun out like the trumpet of a lily, at Grandma Coyne’s house for some occasion, and her taking my chin in one soft, floury hand as I pranced through the kitchen. She told me that I had my father’s face—not like that was a terrific thing. Along with dimples and some smashing cloudy eyes, Dad also had a chin the size of a quarry.
Ta, Sicily
, Grandma said.
Ta, don’t you worry yourself. You’ll grow into that chin
. Just that year, I finally had. The misty eyes inherited from my dad were set in high cheekbones, strong as a scaffolding, making that chin look not protruding but proud. I was playing flirt with the camera, gazing up from under abundant lashes, my smile both tolerant and mischievous, hinting at a knowingness I did not yet quite possess. An energy sprang from that picture—that of a girl who had begun to understand the joyous potential of her supple body and smooth skin.

I still had that hair. I styled it carefully and had two good inches trimmed twice a year. Mom had refused my demands to cut it all off. By the time my mother died, my many surgeries had left my face shaped roughly like the face of a snowman, if that snowman had been put together from bits of cheap plastic in slightly different colors. The strange contours had the effect of making it seem that I was wearing some kind of mask; this, in turn, had the effect of making my hair, which had escaped the fire with nothing but a frizzle here and there, look fake too, like a wig. It also itched like a hill of red ants whenever my hair touched the places where I was healing. Mom got it off my neck by plaiting it into a flat intricate braid she then looped up and pinned in a barrette. Half the time, I pulled it out, telling her I not only looked like a monster but a monster whose mother made her look like something that belonged in
The Sound of Music
.

I still had those eyes. They’d always been my best feature, and now they were my communication salvation. You’d be shocked by how much you telegraph with the tiniest smirk or pout. If you had to do it all with a wink or an eye roll, you’d increase your repertoire. I collected eye gestures from other people, like from the memory of poor, doomed Mr. Treadwell with his “twinkling.” Now the repertoire was so much a part of me that I must look like some B actor trying to get noticed in the crowd scene.
Hey! I’m intelligent! Hey! I’m nice! Hey! That was a joke! Don’t be afraid of me!
I fluttered my lashes so much I was surprised I couldn’t lift small weights with my eyelids.

I used my hands too, and not just the way all Italians do but for what I came to think of as DSL (Disfigured Sign Language, as opposed to American Sign Language). I kept my hands soft and impeccably groomed so that I could mime everything from opening a textbook to opening the gut for an appendectomy.

The esteem that normal people get for nickels and dimes cost me thousands of dollars in sweat and effort, and even then sometimes it was denied me. People fled from me, psychically and in fact. Your face is your defining impression on the world. My job was to contradict that impression every day of my life. To do that, you have to be willing to scream, vamp, and pantomime.

I could no longer close my eyes and instantly summon the splendid young girl’s face that once was mine. My own face, and my parents’ faces, had begun to slur away, like ink drawings dissolving under a spilled glass of water. I was becoming one of my distant memories.

After I hung up with Eliza, I slipped out of my dance clothes, showered, and pulled on a triple-XL UIC T-shirt that brushed my knees. Then I stowed my leather briefcase—holding my laptop and separate folders in which I’d placed the notes and sketches from each of that day’s appointments—in my office. My office was no more than an L-shaped niche under a northern skylight—two long banks of laminated ledge with generous decks of shelving above, arrayed with my two desktop computers, my pastels and ink pens, and my sketchbooks. But it was as immaculate as my personal space was a mess—even my pens gradated by shade, the rose next to the carmine, the claret deepening to the maroon. In my home life, because Aunt Marie spoiled me, I was a slob. The cleaner picked up after me.

The only personal space I would allow no one else to lay hands on was the little glass shelf in my bathroom, where my prosthetic nose reposed in its box. I loved my nose, which was truly a triumph of the anaplastologist’s art, down to the minute wires that simulated the tiny veins you have on your nose but never even really see. Wearing it with a thick pasting of the kind of glop makeup that burn victims use, I could, from a distance, appear almost ordinary.

Useful as it was, putting on my face (no pun intended) was always an effort.

It was not one I would make tonight.

I thought briefly of my last appointment that day—with a new client, Dr. Sajid Joshi. When I was ushered in to his office, he had made no attempt to acknowledge my presence, beyond the involuntary spasm of shock no one (no one) could suppress the first time they saw me. Potential clients were all acquaintances of acquaintances: People knew to expect a scarred face, and yet I was always worse than what they could allow themselves to imagine. A handsome man in his forties, Dr. Joshi was speaking on the phone, in
Russian
, with a British accent.

“
Nyet, Nivilit cheyetah
, Irina,” Dr. Joshi said. “
Gravo prieta tu pona
. Bloody hell, Irina.” Smiling, he covered the receiver and glanced at me. “Canceling appointments is one thing. Canceling a surgery when you need it is quite another.”

When he finally hung up but didn’t apologize, I still had to be more than civil to him. I knew I had to sort of groom him, the way that runts, from wolves to chimpanzees, have to fawn over the dominant members of the group. So I said pleasantly, “You used Russian.” I leaned over to place my digital tape recorder between us and checked the microphone. Dr. Joshi gazed frankly down the neckline of my sweater. He didn’t think I saw him do it, and so tenuous is the bridge of credibility between a disfigured person and a normal one—particularly a dominant male—that I dared not call him on it. Dr. Joshi was a hotshot, a future gold mine of projects. “You spoke Russian,” I said again.

“Why, yes.” Dr. Joshi preened. “I speak three languages.” And then he sniffed. If you ever sniff after you say something self-congratulatory, be aware that someone will notice it. It’s an involuntary reflex for conceited people, and I had to be a student of behavior to survive, reading everyone else’s glossary of expressions like a second language, although mine, to them, appeared blank—a pane of lead. Dr. Joshi said, “How is it that you understood?”

“I took a little in college. I just recognized a few words, that’s all.”

“You took
Russian
?” The surgeon couldn’t hide his bafflement.

If you are a sympathetic, aware, and kindly person who would swear up and down that you don’t judge people by their appearance, you still really do think, deep in the nucleus of your being, that someone with a deformity is dumber than you are (unless he’s Stephen Hawking). You’ll still do weird things unintentionally, like talking louder to someone who is perfectly competent but has cerebral palsy.

I had to prove all the time that the inside of my head was not as damaged as the outside. I expected it. Expecting it is not the same as accepting it, particularly if you got up that morning in a foul mood and the day went downhill from there.

I should have nodded politely. Instead, I saw him and raised him one. “I speak five languages. I minored in languages. Italian—my family speaks it a little, but I wanted to be fluent. Latin was required, of course, and I taught myself Spanish when I was in high school. I took Russian because the alphabet was a challenge. Like a game.” I could see from his expression how Dr. Joshi felt about having a young woman with a face as alluring as a catcher’s mitt try to best him, so I quickly added, “You speak it like a native.”

“I was a boy in Moscow,” said Dr. Joshi. “Then we lived in London, where I read at Oxford.” Another sniff. “My mother is Russian, a farmer’s daughter. My father was a Sikh, a surgeon like myself. Forbidden marriage. Much passion. Much quarreling. But five happy children. My mother has many grandchildren now.”

“That’s interesting,” I said. “Unusual. Let’s get started.”

“Of course,” Dr. Joshi said. “But … I would venture that it is you who is unusual in this work. You’re forced to meet people. Is that difficult for you, given …?”

“Given how I look?” I said. The guy was pure gall on a cracker. “It used to be. I do have to factor in that some people will believe things that aren’t true.”

“Such as?”

“That I’m kind of dim-witted and have no sex life,” I said, and then couldn’t believe I actually had.

My aunt Marie used to tell me that if it was socially acceptable to slug disabled people, I would have both eyes on the side of my head, like a painting on the wall of a tomb in Egypt.

Dr. Joshi was too dark-skinned to really blush, but he fumbled, dropping his laptop as he turned toward the projection screen. We both held our breath, but the unit was undamaged, and Dr. Joshi quickly—almost too quickly—marched through the succession of photos of the technique he had pioneered. The new procedure would allow surgeons to use a smaller cannula to implant genetically engineered cells into a herniated disc, making the repair a rather neat office procedure. This was only the first interview I would need. Later, I’d use my rough sketches to make finer sketches of the progressive steps I’d created from my own drawings and then with the drawing programs on one of my three Macs. My final sketches—the whole procedure minus the gore—were what a medical illustrator does. They would make plain and to scale, in the paper Dr. Joshi would present, what photographs could not show. I did drawings and even animations in the same way for professors to use in teaching. For lawyers, my drawings made injuries specific in court without causing jurors to throw up. As I sketched, though I was being careful, I also was thinking that when I got home I’d find a message blinking on my office phone, telling me that “Doctor” had decided to proceed another way. When I stood up to leave, however, to my shock and his credit, Dr. Joshi extended his hand. He said, “I’m sorry I offended you.”